Severe Stress and Depression Increase Risk of Early Death

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Stress and depression can take a dangerous toll on the health of
people with heart problems, a new study finds.

People in the study who had high levels of both stress and
depression were 48 percent more likely to die or have a heart
attack during the study period, compared with the group that had
low levels of stress and
depression, the researchers said.

For people who already have heart problems, the combination of
stress and severe depression creates a "psychosocial perfect
storm," the researchers said in their study, published online
today (March 10) in the journal
Circulation: Cardiovascular Quality and Outcomes.

"The increase in risk accompanying high stress and high
depressive symptoms was robust and consistent across
demographics, medical history, medication use and health risk
behaviors," the study's lead author, Carmela Alcántara, an
associate research scientist at Columbia University Medical
Center in New York City, said in a statement. [ 11 Tips
to Lower Stress ]

The study included nearly 5,000 people with coronary heart
disease who were 45 years or older. The participants shared their
symptoms of depression and stress during in-home examinations and
on questionnaires that were conducted from 2003 through 2007. For
example, the participants answered questions on how often they
had felt lonely or had crying spells during the past week, and
how often they felt unable to control important things in their
lives or felt overwhelmed during the past month.

About 6 percent, or 274 people in the study, reported having both
high stress and high depression, the researchers found. After a
six-year follow-up, there were 1,337 deaths or heart attacks
among the people in the study.

The researchers noted that the "high vulnerability period,"during
which people with intense stress and depression were at increased
risk of dying or having a heart attack lasted about two and a
half years, but after that, the increase in risk disappeared.

They also found that people who had only high stress, or had only
high depressive symptoms, but not both depression and stress at
the same time, did not have an increased risk of death or heart
attack.

Many treatment programs look at depression's effects on people
with heart disease, but the new findings may help stress
management enter that equation, Alcántara said. For instance,
behavioral interventions may help people with heart
disease manage both their stress and their depression, she said.